How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $0.38 Median $0.38 Typical High $1.70 | Facility | None | $0.38 | $0.38 | $1.70 |
Aetna Setting Professional Modifier None Typical Low $0.38 Median $0.38 Typical High $1.00 | Professional | None | $0.38 | $0.38 | $1.00 |
AllWays Health Partners Setting Facility Modifier None Typical Low $0.83 Median $0.87 Typical High $2.82 | Facility | None | $0.83 | $0.87 | $2.82 |
AllWays Health Partners Setting Professional Modifier None Typical Low $0.37 Median $0.89 Typical High $4.47 | Professional | None | $0.37 | $0.89 | $4.47 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $0.98 Median $1.15 Typical High $1.51 | Facility | None | $0.98 | $1.15 | $1.51 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $0.55 Median $0.55 Typical High $0.63 | Professional | None | $0.55 | $0.55 | $0.63 |
Cigna Setting Professional Modifier None Typical Low $0.45 Median $0.45 Typical High $0.62 | Professional | None | $0.45 | $0.45 | $0.62 |
Fallon Health Setting Facility Modifier None Typical Low $83.18 Median $3,630.78 Typical High $9,772.37 | Facility | None | $83.18 | $3,630.78 | $9,772.37 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $0.34 Median $0.78 Typical High $0.85 | Professional | None | $0.34 | $0.78 | $0.85 |
Mass General Brigham Setting Facility Modifier None Typical Low $0.83 Median $0.87 Typical High $2.82 | Facility | None | $0.83 | $0.87 | $2.82 |
Mass General Brigham Setting Professional Modifier None Typical Low $0.37 Median $0.89 Typical High $4.47 | Professional | None | $0.37 | $0.89 | $4.47 |
United Setting Professional Modifier None Typical Low $0.28 Median $0.44 Typical High $0.85 | Professional | None | $0.28 | $0.44 | $0.85 |
Well Sense Setting Facility Modifier None Typical Low $0.72 Median $1.00 Typical High $1.51 | Facility | None | $0.72 | $1.00 | $1.51 |
Well Sense Setting Professional Modifier None Typical Low $0.54 Median $0.54 Typical High $0.65 | Professional | None | $0.54 | $0.54 | $0.65 |
4 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $0.19 Median $0.19 Typical High $0.85 | Professional | 52 · Reduced service | $0.19 | $0.19 | $0.85 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.08 Median $0.08 Typical High $0.34 | Professional | 53 · Discontinued | $0.08 | $0.08 | $0.34 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.06 Median $0.06 Typical High $0.26 | Professional | 55 · Aftercare only | $0.06 | $0.06 | $0.26 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.04 Median $0.04 Typical High $0.17 | Professional | 56 · Pre-op care only | $0.04 | $0.04 | $0.17 |
Where Massachusetts sits
The same service costs 2.6 times more in Hawaii than in Utah. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Massachusetts· 14th of 51
$0.72
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.